Healthcare Provider Details

I. General information

NPI: 1568718773
Provider Name (Legal Business Name): KATELYN ELIZABETH YLITALO PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2012
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 TANGLEWOOD PKWY N
ELIZABETH CITY NC
27909-7788
US

IV. Provider business mailing address

101 TANGLEWOOD PKWY N
ELIZABETH CITY NC
27909-7788
US

V. Phone/Fax

Practice location:
  • Phone: 252-338-2354
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61173890
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34251
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2032
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number61173890
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS50522
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number055715
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: